Healthcare Provider Details

I. General information

NPI: 1235601584
Provider Name (Legal Business Name): ARLINGTON DC BEHAVIOR THERAPY INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2018
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WILSON BLVD STE 210
ARLINGTON VA
22201-3324
US

IV. Provider business mailing address

2200 WILSON BLVD STE 210
ARLINGTON VA
22201-3324
US

V. Phone/Fax

Practice location:
  • Phone: 202-557-5174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: JOHN BENNER
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 703-822-5336